Talking about quality: How 'quality' is conceptualized in nursing homes and homecare
BMC Health Services Research , Volume 21 - Issue 104
Background: The delivery of high-quality service in nursing homes and homecare
requires collaboration and shared understanding among managers, employees, users
and policy makers from across the healthcare system. However, conceptualizing
healthcare professionals’ perception of quality beyond hospital settings (e.g., its
perspectives, defining attributes, quality dimensions, contextual factors, dilemmas) has
rarely been done. This study therefore explores the meaning of “quality” among
healthcare managers and staff in nursing homes and homecare.
Methods: The study applies a cross-sectional qualitative design with focus groups and individual interviews, to capture both depth and breadth of conceptualization of quality from healthcare professionals in nursing homes and homecare. We draw our data from 65 managers and staff in nursing homes and homecare services in Norway and the Netherlands. The participants worked as managers (n =40), registered nurses (RNs) or assistant nurses (n =25).
Results: The analysis identified the two categories and four sub-categories: “Professional issues: more than firefighting” (subcategories “professional pride” and “competence”) and “patient-centered approach: more than covering basic needs” (subcategories “dignity” and “continuity”). Quality in nursing homes and homecare is conceptualized as an ongoing process based on having the “right competence,” good cooperation across professional groups, and patient-centered care, in line with professional pride and dignity for the patients.
Conclusion: Based on the understanding of quality among the healthcare professionals in our study, quality should encompass the softer dimensions of professional pride and competence, as well as a patient-centered approach to care. These dimensions should be factors in improvement activities and in daily practice.
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|BMC Health Services Research|
|Organisation||Rotterdam School of Management (RSM), Erasmus University|